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coronary microvascular dysfunction

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https://www.readbyqxmd.com/read/28807722/coronary-microvascular-dysfunction-is-not-associated-with-a-history-of-reproductive-risk-factors-in-women-with-angina-pectoris-an-ipower-substudy
#1
Hannah Elena Suhrs, Anna Meta Kristensen, Anna Bay Rask, Marie Mide Michelsen, Daria Frestad, Naja Dam Mygind, Kira Bové, Eva Prescott
BACKGROUND: Reproductive risk factors such as preeclampsia and recurrent miscarriages have been associated with adverse cardiovascular (CV) events. Underlying coronary microvascular dysfunction (CMD) may be a common denominator. PURPOSE: We investigated whether a history of reproductive risk factors was associated with CMD in women with angina pectoris and no obstructive coronary artery disease (CAD). METHODS: Participants from the iPOWER study, including women with angina pectoris and no obstructive CAD (<50% stenosis), were invited to complete an electronic survey regarding reproductive risk factors: recurrent miscarriages, gestational diabetes, preeclampsia, rhesus immunity, polycystic ovary syndrome and menopausal status as well as migraine and Raynaud phenomenon...
August 11, 2017: Maturitas
https://www.readbyqxmd.com/read/28807510/angina-after-percutaneous-coronary-intervention-the-need-for-precision-medicine
#2
Giampaolo Niccoli, Rocco Antonio Montone, Gaetano Antonio Lanza, Filippo Crea
Persistence or recurrence of angina after successful percutaneous coronary intervention (PCI) represent an important clinical issue involving from one fifth to one third of patients undergoing myocardial revascularization at one-year follow-up. A systematic approach to this syndrome is strongly needed. Precision medicine is particularly important in addressing angina after successful PCI because of the multiple underlying causes. Restenosis or coronary atherosclerosis progression explain symptom recurrence after successful PCI in some patients, while functional causes, including vasomotor abnormalities of epicardial coronary arteries and/or coronary microvascular dysfunction, explain symptoms in the remaining patients...
August 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28794138/quantitative-assessment-of-coronary-microvascular-function-dynamic-single-photon-emission-computed-tomography-positron-emission-tomography-ultrasound-computed-tomography-and-magnetic-resonance-imaging
#3
Attila Feher, Albert J Sinusas
A healthy, functional microcirculation in combination with nonobstructed epicardial coronary arteries is the prerequisite of normal myocardial perfusion. Quantitative assessment in myocardial perfusion and determination of absolute myocardial blood flow can be achieved noninvasively using dynamic imaging with multiple imaging modalities. Extensive evidence supports the clinical value of noninvasively assessing indices of coronary flow for diagnosing coronary microvascular dysfunction; in certain diseases, the degree of coronary microvascular impairment carries important prognostic relevance...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28782150/mri-assessment-of-coronary-microvascular-endothelial-nitric-oxide-synthase-function-using-myocardial-t1-mapping
#4
Sophia X Cui, Frederick H Epstein
PURPOSE: Endothelial nitric oxide synthase (eNOS) plays a central role in regulating vascular tone, blood flow, and microvascular permeability. Endothelial dysfunction, including eNOS dysfunction, is an early biomarker of vascular disease. This study aimed to show that myocardial T1 mapping during nitric oxide synthase (NOS) inhibition could assess coronary microvascular eNOS function. METHODS: Wild-type mice, eNOS(-/-) mice, and wild-type mice fed a high-fat diet underwent T1 mapping at baseline and for 20 min after injection of N(G) -nitro-L-arginine methyl ester (LNAME), a NOS inhibitor...
August 7, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28782082/utility-of-imaging-in-risk-stratification-of-chest-pain-in-women
#5
REVIEW
Emily S Lau, Amy Sarma
Recent decades have seen a growing recognition that the understanding of sex differences in cardiovascular disease (CVD) is vital to optimal diagnosis and management, particularly of women (Mosca et al. Circulation 124:2145-54, 2011). There is simultaneously an increasing appreciation of the multifactorial nature of ischemic heart disease (IHD) in many patients, in whom disease may extend beyond the epicardial coronaries. While obstructive coronary artery disease (CAD) remains underdiagnosed in women and still represents a major burden of disease, women also present with nonobstructive CAD more commonly than men (Patel et al...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28769873/targeting-obesity-and-diabetes-to-treat-heart-failure-with-preserved-ejection-fraction
#6
REVIEW
Raffaele Altara, Mauro Giordano, Einar S Nordén, Alessandro Cataliotti, Mazen Kurdi, Saeed N Bajestani, George W Booz
Heart failure with preserved ejection fraction (HFpEF) is a major unmet medical need that is characterized by the presence of multiple cardiovascular and non-cardiovascular comorbidities. Foremost among these comorbidities are obesity and diabetes, which are not only risk factors for the development of HFpEF, but worsen symptoms and outcome. Coronary microvascular inflammation with endothelial dysfunction is a common denominator among HFpEF, obesity, and diabetes that likely explains at least in part the etiology of HFpEF and its synergistic relationship with obesity and diabetes...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28761673/evaluation-of-intermediate-coronary-stenoses-in-acute-coronary-syndromes-using-pressure-guidewire
#7
REVIEW
Giampaolo Niccoli, Ciro Indolfi, Justin E Davies
Fractional flow reserve (FFR) is increasingly used to guide myocardial revascularisation. However, supporting evidence regarding its use originates from studies that have enrolled mainly patients with stable angina, while patients with acute coronary syndromes (ACS) have not been included. Notably, multifactorial microvascular dysfunction and an increased sympathetic tone in patients with ACS may lead to blunted response to adenosine and false-negative results of FFR due to submaximal hyperaemia. This may raise the possibility of deferring treatment of stenosis that instead would have needed dilatation, thus leaving a residual risk of preventable cardiac events...
2017: Open Heart
https://www.readbyqxmd.com/read/28758150/diabetes-and-cardioplegia
#8
Brittany A Potz, Laura A Scrimgeour, Jun Feng, Frank W Sellke
Cardiac surgery with cardiopulmonary bypass and cardioplegic arrest is associated with injury to the vasculature and microcirculation leading to coronary microvascular dysfunction, permeability changes and cardiac dysfunction. In the setting of cardiopulmonary bypass with cardioplegia, poorly-controlled diabetes is associated with significant changes in endothelium-dependent and independent vascular dysfunction, vascular reactivity, vascular permeability, protein expression, cell death, coronary/peripheral microcirculation and reduced vasomotor tone leading to hypotension and impaired endothelial function...
June 2017: Journal of Nature and Science
https://www.readbyqxmd.com/read/28754439/myocardial-blood-flow-reserve-is-impaired-in-patients-with-aortic-valve-calcification-and-unobstructed-epicardial-coronary-arteries
#9
Karen Nel, Michael C Y Nam, Chris Anstey, Christopher J Boos, Edward Carlton, Roxy Senior, Juan Carlos Kaski, Ahmed Khattab, Delva Shamley, Christopher D Byrne, Tony Stanton, Kim Greaves
BACKGROUND: Although calcific aortic valve disease (CAVD) is associated with coronary atherosclerosis, it is not known whether early CAVD is associated with coronary microcirculatory dysfunction (CMD). We sought to investigate the relationship between myocardial blood flow reserve (MBFR) - a measure of CMD, and early CAVD in the absence of obstructive epicardial coronary artery disease. We also determined whether this relationship was independent of coronary artery disease (CAD) and hs-CRP, a marker of systemic inflammation...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28749565/melatonin-suppresses-platelet-activation-and-function-against-cardiac-ischemia-reperfusion-injury-via-ppar%C3%AE-fundc1-mitophagy-pathways
#10
Hao Zhou, Dandan Li, Pingjun Zhu, Shunying Hu, Nan Hu, Sai Ma, Ying Zhang, Tianwen Han, Jun Ren, Feng Cao, Yundai Chen
Platelet activation is a major (patho-) physiological mechanism that underlies ischemia/reperfusion (I/R) injury. In this study, we explored the molecular signals for platelet hyperactivity and investigated the beneficial effects of melatonin on platelet reactivity in response to I/R injury. After reperfusion, peroxisome proliferator-activated receptor γ (PPARγ) was progressively downregulated in patients with acute myocardial infarction undergoing coronary artery bypass grafting (CABG) surgery and in mice with I/R injury model...
July 27, 2017: Journal of Pineal Research
https://www.readbyqxmd.com/read/28746811/the-acute-effects-of-different-spironolactone-doses-on-cardiac-function-in-streptozotocin-induced-diabetic-rats
#11
Aleksandra Vranic, Stefan Simovic, Petar Ristic, Tamara R Nikolic, Isidora Stojic, Ivan M Srejovic, Vladimir I Zivkovic, Vladimir Jakovljevic, Dusan Djuric
Currently, cardiovascular diseases are leading cause of global mortality, while diabetes mellitus remains an important cause of cardiovascular morbidity. Findings suggest that obesity and diabetes mellitus are closely interconnected with high aldosterone levels, while mineralocorticoid receptors antagonist therapy has shown positive effects on cardiovascular complications associated with diabetes mellitus. A recent study showed that patients with diabetes mellitus treated with mineralocorticoid receptors antagonist have improved coronary microvascular function, leading to improved diastolic dysfunction...
July 26, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28733074/non-invasive-assessment-of-microvascular-dysfunction-in-patients-with-microvascular-angina
#12
Caroline Jaarsma, Hans Vink, Judith van Haare, Sebastiaan C A M Bekkers, Bart D van Rooijen, Walter H Backes, Joachim E Wildberger, Harry J Crijns, Jurgen van Teeffelen, Simon Schalla
BACKGROUND: We aimed to evaluate the microvascular function in patients with microvascular angina (MVA) by assessing 1) the endothelial glycocalyx barrier properties using sublingual microscopy, and 2) the myocardial perfusion reserve using cardiovascular magnetic resonance (CMR) imaging. METHODS: Sublingual microscopy was performed in 13 MVA patients (angina pectoris, ST-depression on treadmill testing, normal coronary angiogram) and compared with 2 control groups of 13 volunteers and 14 patients with known obstructive coronary artery disease (CAD)...
July 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28700893/coronary-microvascular-disease-as-an-early-culprit-in-the-pathophysiology-of-diabetes-and-metabolic-syndrome
#13
REVIEW
Hicham Labazi, Aaron J Trask
Metabolic syndrome (MetS) is a group of cardio-metabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidemia; these are also a combination of independent coronary artery disease (CAD) risk factors. Alarmingly, the prevalence of MetS risk factors are increasing and a leading cause for mortality. In the vasculature, complications from MetS and type 2 diabetes (T2D) can be divided into microvascular (retinopathy and nephropathy) and macrovascular (cardiovascular diseases and erectile dysfunction)...
July 9, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28699071/microvascular-dysfunction-in-infiltrative-cardiomyopathies
#14
Ornella Rimoldi, Francesco Maranta
Infiltrative heart diseases are characterized by myocardial tissue alterations leading to mechanical dysfunction which in turn develops into bi-ventricular congestive heart failure. Also the coronary microvasculature undergoes significant remodeling and dysfunction. The effects of the unbalance of the mechanical cross-talk between cardiac muscle and vessels and of the impairment of vasodilatory function can be measured non-invasively by means of positron emission tomography and cardiac magnetic resonance.
July 11, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28685679/clinical-approach-to-diabetic-cardiomiopathy-a-review-of-human-studies
#15
Roberto Tarquini, Laura Pala, Simona Brancati, Giulia Vannini, Salvatore De Cosmo, Gianluigi Mazzoccoli, Carlo Maria Rotella
BACKGROUND: Diabetic Cardiomiopathy (DC) has been defined as a distinct entity characterized by the presence of diastolic or systolic cardiac dysfunction in a diabetic patient in the absence of other causes for Cardiomiopathy, such as coronary artery disease (CAD), hypertension (HTN), or valvular heart disease. Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population. Diabetes-related heart disease occurs in the form of coronary artery disease (CAD), cardiac autonomic neuropathy or DC...
July 5, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28683825/diabetic-retinopathy-is-associated-with-diastolic-dysfunction-in-type-2-diabetic-patients-with-non-ischemic-dilated-cardiomyopathy
#16
Yoo-Ri Chung, Se-Jun Park, Ka Young Moon, Seoyoung Annie Choi, Hong-Seok Lim, Sung Wook Park, Jeong Hun Kim, Kihwang Lee
BACKGROUND: To investigate the association between diabetic retinopathy (DR) and myocardial dysfunction in patients with type 2 diabetes and dilated cardiomyopathy (dCMP). METHODS: Data were collected retrospectively from 89 patients with dCMP (46 with type 2 diabetes and 43 without diabetes) and no evidence of coronary artery disease. Echocardiographic parameters and laboratory data, including lipid profiles and fundus findings, were obtained from medical records...
July 6, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28668140/clinical-features-diagnosis-and-management-of-patients-with-anderson-fabry-cardiomyopathy
#17
REVIEW
Haran Yogasundaram, Daniel Kim, Omar Oudit, Richard B Thompson, Frank Weidemann, Gavin Y Oudit
Anderson-Fabry disease (AFD) is an X-linked recessive, multisystem disease of lysosomal storage. A mutation in the gene encoding the hydrolase enzyme α-galactosidase A results in its deficiency, or complete absence of activity. Subsequent progressive intracellular accumulation of glycosphingolipids, predominantly globotriaosylceramide, in various tissues, results in progressive organ dysfunction and failure, most commonly affecting the kidneys, nervous system, skin, eyes, vascular endothelium, and the heart...
July 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28663361/hyperaemic-microvascular-resistance-predicts-clinical-outcome-and-microvascular-injury-after-myocardial-infarction
#18
Guus A de Waard, Gregor Fahrni, Douwe de Wit, Hironori Kitabata, Rupert Williams, Niket Patel, Paul F Teunissen, Peter M van de Ven, Sabahattin Umman, Paul Knaapen, Divaka Perera, Takashi Akasaka, Murat Sezer, Rajesh K Kharbanda, Niels van Royen
OBJECTIVES: Early detection of microvascular dysfunction after acute myocardial infarction (AMI) could identify patients at high risk of adverse clinical outcome, who may benefit from adjunctive treatment. Our objective was to compare invasively measured coronary flow reserve (CFR) and hyperaemic microvascular resistance (HMR) for their predictive power of long-term clinical outcome and cardiac magnetic resonance (CMR)-defined microvascular injury (MVI). METHODS: Simultaneous intracoronary Doppler flow velocity and pressure measurements acquired immediately after revascularisation for AMI from five centres were pooled...
June 29, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28653394/ranolazine-reduces-repolarization-heterogeneity-in%C3%A2-symptomatic-patients-with-diabetes-and-non-flow-limiting-coronary-artery-stenosis
#19
Ederson Evaristo, Fernando G Stocco, Nishant R Shah, Michael K Cheezum, Jon Hainer, Courtney Foster, Bruce D Nearing, Marcelo Di Carli, Richard L Verrier
BACKGROUND: Experimental evidence suggests that ranolazine decreases susceptibility to ischemia-induced arrhythmias independent of effects on coronary artery blood flow. OBJECTIVE: In symptomatic diabetic patients with non-flow-limiting coronary artery stenosis with diffuse atherosclerosis and/or microvascular dysfunction, we explored whether ranolazine reduces T-wave heterogeneity (TWH), an electrocardiographic (ECG) marker of arrhythmogenic repolarization abnormalities shown to predict sudden cardiac death...
June 27, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28653314/fractional-flow-reserve-based-therapy-in-patients-presenting-with-acute-coronary-syndrome-current-data-and-everyday-practice
#20
Grzegorz Zuk, Dariusz Ciecwierz, Natalia Cwalina, Marcin Gruchala, Florim Cuculi
Fractional flow reserve (FFR) is an evidence-based diagnostic tool of physiological significance of coronary artery stenosis in patients with stable coronary artery disease (CAD). Due to microvascular dysfunction in acute coronary syndrome (ACS), information obtained from FFR assessment could be less reliable and, thus, its clinical role remains controversial. Indeed, results of currently published studies are essentially discrepant. Only a few randomized clinical trials have been performed showing the efficacy of FFR-guided percutaneous coronary intervention (PCI) in ACS...
June 27, 2017: Cardiology Journal
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